CROSS-REFERENCE
BACKGROUND
[0002] Electrochemical sensors have long been used to detect or measure the presence of
substances in fluid samples. Electrochemical sensors include a reagent mixture containing
at least an electron transfer agent (also referred to as an "electron mediator") and
an analyte specific bio-catalytic protein (e.g. a particular enzyme), and one or more
electrodes. Such sensors rely on electron transfer between the electron mediator and
the electrode surfaces and function by measuring electrochemical redox reactions.
When used in an electrochemical biosensor system or device, the electron transfer
reactions are monitored via an electrical signal that correlates to the concentration
of the analyte being measured in the fluid sample.
[0003] The use of such electrochemical sensors to detect analytes in bodily fluids, such
as blood or blood derived products, tears, urine, and saliva, has become important,
and in some cases, vital to maintain the health of certain individuals. In the health
care field, people such as diabetics, for example, must monitor a particular constituent
within their bodily fluids. A number of systems are capable of testing a body fluid,
such as, blood, urine, or saliva, to conveniently monitor the level of a particular
fluid constituent, such as, cholesterol, proteins, and glucose. Patients suffering
from diabetes, a disorder of the pancreas where insufficient insulin production prevents
the proper digestion of sugar, have a need to carefully monitor their blood glucose
levels on a daily basis. Routine testing and controlling blood glucose for people
with diabetes can reduce their risk of serious damage to the eyes, nerves, and kidneys.
[0004] Electrochemical biosensors may be adversely affected by the presence of certain blood
components that may undesirably affect the measurement and lead to inaccuracies in
the detected signal. This inaccuracy may result in an inaccurate glucose reading,
leaving the patient unaware of a potentially dangerous blood sugar level, for example.
As one example, the blood hematocrit level (i.e. the percentage of the amount of blood
that is occupied by red blood cells) can erroneously affect a resulting analyte concentration
measurement.
[0005] Variations in a volume of red blood cells within blood can cause variations in glucose
readings measured with disposable electrochemical test strips. Typically, a negative
bias (i.e., lower calculated analyte concentration) is observed at high hematocrit,
while a positive bias (i.e., higher calculated analyte concentration) is observed
at low hematocrit. At high hematocrit, for example, the red blood cells may impede
the reaction of enzymes and electrochemical mediators, reduce the rate of chemistry
dissolution since there is less plasma volume to solvate the chemical reactants, and
slow diffusion of the mediator. These factors can result in a lower than expected
glucose reading as less current is produced during the electrochemical process. Conversely,
at low hematocrit, fewer red blood cells may affect the electrochemical reaction than
expected, and a higher measured current can result. In addition, the blood sample
resistance is also hematocrit dependent, which can affect voltage and/or current measurements.
[0006] Several strategies have been used to reduce or avoid hematocrit based variations
on blood glucose. For example, test strips have been designed to incorporate meshes
to remove red blood cells from the samples, or have included various compounds or
formulations designed to increase the viscosity of red blood cell and attenuate the
affect of low hematocrit on concentration determinations. Other test strips have included
lysis agents and systems configured to determine hemoglobin concentration in an attempt
to correct hematocrit. Further, biosensors have been configured to measure hematocrit
by measuring optical variations after irradiating the blood sample with light, or
measuring hematocrit based on a function of sample chamber fill time. These methods
have certain disadvantages.
SUMMARY OF THE DISCLOSURE
[0007] Applicants have recognized a need for a system and method that can be used to determine
an accurate glucose concentration that avoids the disadvantages in the field.
[0008] In view of the foregoing and in accordance with one aspect, there is provided a method
of operating an analyte measurement system having a meter and a test strip. The test
strip may include a reference electrode, a first working electrode and a second working
electrode in which the first and second working electrodes are coated with a first
and second reagent layer, respectively. The respective first and second reagent layers
are disposed on a matrix layer having a mediator. The meter may include an electronic
circuit for applying a test voltage between the reference electrode and the first
working electrode and for applying a second test voltage between the reference electrode
and the second working electrode. The meter also may include a signal processor for
measuring a plurality of test currents and for calculating a glucose concentration
from the test currents. The method may be achieved by applying a test voltage between
the reference electrode and the second working electrode; measuring a first test current,
a second test current and a third test current at the working electrode with the meter
after a blood sample containing an analyte is applied to the test strip; ascertaining
the glucose concentration from the first, second and third test currents; and displaying
the glucose concentration.
[0009] In the exemplary method, the glucose concentration may be a value obtained with the
following:

where:
G includes the hematocrit-corrected glucose concentration;
I1 includes the first test current;
I2 includes the second test current;
I3 includes the third test current;
p includes a power term;
intercept1 includes an intercept value determined from a linear regression of a plot of

versus a reference glucose concentration; and
slope1 includes a slope value determined from a linear regression of a plot of

versus the reference glucose concentration.
[0010] In such embodiment, the power term p depends on a threshold value of the first test
current
I1 and may be from about one to about four. If the first test current
I1 includes above the threshold value, then the above equation is used to calculate
the hematocrit-corrected glucose concentration
G. If the first test current
I1 is at or below the threshold value, then the power term
p is set to zero in the above equation and the term

becomes one. The threshold value of the first test current
I1 may be from about 4 microamperes to about 7 microamperes.
[0011] In another embodiment, the power term p may include a value obtained with the following:

where
a includes a first tuning parameter and
b includes a second tuning parameter.
[0012] In one embodiment, each of first and second tuning parameters
a and
b is from about zero to about five.
[0013] In another embodiment, batch-specific tuning parameters
a and
b may be determined by a calculating a first power term for a first combination of
the first tuning parameter and the second tuning parameter with the following:

where
p1 includes the first power term;
ascertaining the current for each of a plurality of samples tested with the batch
of test strips with the following:

where
Icorrected includes the hematocrit-corrected current;
computing a slope and intercept from a linear regression of a plot of hematocrit-corrected
current versus a reference plasma glucose concentration;
estimating a hematocrit-corrected glucose concentration for each of the plurality
of samples with the following:

where
Gcorrected includes the hematocrit-corrected glucose concentration,
intercept2 includes an intercept value determined from a linear regression of a plot
of Icorrected versus a reference glucose concentration and
slope2 includes a slope value determined from a linear regression of a plot of
Icorrected versus a reference glucose concentration;
evaluating a bias for each of the hematocrit-corrected glucose concentrations with
equations of the form:

and

where
Biasabs includes absolute bias,
Bias% includes percent bias and
Greference includes the reference glucose concentration;
estimating accuracy for the first combination of the first and second tuning parameters
with the following:

where
n15 includes the number of data points within a bias criteria and
n includes the total number of data points;
computing a hematocrit slope from a linear regression of a plot of the bias versus
the percent hematocrit;
establishing a standard deviation of the bias with the following:

where s includes the standard deviation,
n includes the number of samples,
xi includes the sample and x includes the mean of the sample;
repeating the previous steps for all combinations of the first and second tuning parameters;
plotting an accuracy calibration space of the accuracy calibration space for all combinations
of the first and second tuning parameters; plotting an accuracy calibration space
of the hematocrit slope calibration space for all combinations of the first and second
tuning parameters; generating a combined surface plot for all combinations of the
first and second tuning parameters which meet an accuracy and hematocrit slope acceptance
criteria; and determining batch-specific first and second tuning parameters from the
combined surface plot.
[0014] In another embodiment, the method of determining batch-specific tuning parameters
further may include determining a set of batch-specific calibration parameters, e.g.,
slope and intercept.
[0015] In yet another embodiment, the method of determining batch-specific tuning parameters
further may include determining tuning parameters for multiple batches of test strips
and then determining regions of overlap for all the batches in the combined surface
plots of the accuracy calibration space and the hematocrit slope calibration space.
[0016] In yet a further embodiment, a method for determining a hematocrit-corrected test
current measurable with a system having a test strip and a meter is provided. The
method can be achieved by applying a test voltage between a reference electrode and
a working electrode coated with a reagent layer disposed on a matrix layer having
a mediator; measuring a first test current, a second test current and a third test
current at the working electrode with the meter after a blood sample containing an
analyte is applied to the test strip; and ascertaining a hematocrit-corrected test
current via a ratio of the first test current to the second test current raised to
a power term and multiplying the ratio by the third test current, in which the power
term is a function of a first tuning parameter and a second tuning parameter.
[0017] In yet a further embodiment, an analyte measurement system to measure at least glucose
concentration in physiological fluid of a user is provided. The system includes a
test strip and a meter. The test strip includes a substrate having a reference electrode
and a working electrode coated with a reagent layer, which is disposed on a matrix
layer having a mediator. The electrodes are connected to corresponding contact pads.
The analyte meter has a test circuit in connection with a test strip port that receives
the contact pads of the test strip so that the meter is configured to apply a test
voltage after deposition of physiological fluid on the electrodes and determine a
hematocrit-corrected the glucose concentration from measured first, second and third
test currents at first, second, and third discrete intervals after application of
the test voltage by the meter.
[0018] These and other embodiments, features and advantages of the invention will become
apparent to those skilled in the art when taken with reference to the following more
detailed description of the exemplary embodiments in conjunction with the accompanying
drawings that are first briefly described.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] The accompanying drawings, which are incorporated herein and constitute part of this
specification, illustrate presently preferred embodiments of the invention, and, together
with the general description given above and the detailed description given below,
serve to explain features of the invention (in which like numerals represent like
elements), of which:
[0020] Figure 1 illustrates an exemplary embodiment of a top view of a system for measuring
two analyte concentrations;
[0021] Figure 2 illustrates an exemplary embodiment of a perspective exploded view of a
test strip;
[0022] Figure 3 illustrates an exemplary embodiment of a top view of the test strip shown
in Figure 2;
[0023] Figure 4 illustrates an exemplary embodiment of a schematic of the functional components
of the meter shown in Figure 1 forming an electrical connection with the test strip
of Figures 2 and 3;
[0024] Figure 5A illustrates an exemplary embodiment of a flow chart of a method of estimating
a hematocrit-corrected glucose concentration using the system shown in Figure 1;
[0025] Figure 6 illustrates an exemplary embodiment of a chart showing test voltages applied
by the meter to the test strip;
[0026] Figure 7 illustrates an exemplary embodiment of a chart showing test currents generated
when the test voltages of Figure 6 are applied to the test strip;
[0027] Figure 8 illustrates an exemplary embodiment of a surface plot of the accuracy calibration
space for all combinations of the first tuning parameter and the second tuning parameter
for a batch of test strips having the embodiment shown in Figures 2 and 3;
[0028] Figure 9 illustrates an exemplary embodiment of a surface plot of the hematocrit
slope calibration space for all combinations of the first tuning parameter and the
second tuning parameter for a batch of test strips having the embodiment shown in
Figures 2 and 3;
[0029] Figure 10 illustrates an exemplary embodiment of a combined surface plot for all
combinations of the first and second tuning parameters which meet an accuracy and
hematocrit slope acceptance criteria and using the data in Figures 8 and 9;
[0030] Figures 11A and 11B illustrate Clarke Error Grid analysis showing test glucose concentration
plotted as a function of reference glucose concentration prior to and after applying
an exemplary embodiment to the test data, respectively. The test data was obtained
with a batch of test strips having the embodiment shown in Figures 2 and 3; and
[0031] Figures 11C and 11D illustrate Parkes Error Grid analysis showing test glucose concentration
plotted as a function of reference glucose concentration prior to and after applying
an exemplary embodiment to the test data, respectively. The test data in Figures 11A
and 11B was used along with additional data and after applying a suitable error trapping.
DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS
[0032] The following detailed description should be read with reference to the drawings,
in which like elements in different drawings are identically numbered. The drawings,
which are not necessarily to scale, depict selected embodiments and are not intended
to limit the scope of the invention. The detailed description illustrates by way of
example, not by way of limitation, the principles of the invention. This description
will clearly enable one skilled in the art to make and use the invention, and describes
several embodiments, adaptations, variations, alternatives and uses of the invention,
including what is presently believed to be the best mode of carrying out the invention.
[0033] As used herein, the terms "about" or "approximately" for any numerical values or
ranges indicate a suitable dimensional tolerance that allows the part or collection
of components to function for its intended purpose as described herein. In addition,
as used herein, the terms "patient," "host," "user," and "subject" refer to any human
or animal subject and are not intended to limit the systems or methods to human use,
although use of the subject invention in a human patient represents a preferred embodiment.
[0034] Figure 1 illustrates a system 100 for measuring at least two analyte concentrations
in which system 100 may include a meter 102 and a test strip 200. Meter 102 may include
a display 104, a housing 106, a plurality of user interface buttons 108, and a strip
port 110. Meter 102 further may include electronic circuitry within housing 106 such
as a memory 120, a microprocessor 122, electronic components for applying a test voltage,
and also for measuring at least two test current values. A proximal portion 204 of
test strip 200 may be inserted into strip port 110. Display 104 may output at least
two analyte concentrations, e.g., glucose and/or a ketone concentration, and may be
used to show a user interface for prompting a user on how to perform a test. The plurality
of user interface buttons 108 allow a user to operate meter 102 by navigating through
the user interface software. Display 104 may optionally include a backlight.
[0035] An optional data port 114 accepts a suitable connector attached to a connecting lead,
thereby allowing meter 102 to be linked to an external device such as a personal computer.
Data port 114 may be any port that allows for transmission of data (serial or parallel)
such as, for example, serial or parallel port in wired or wireless form. A personal
computer, running appropriate software, allows entry and modification of set-up information
(e.g. the current time, date, and language), and may perform analysis of data collected
by meter 102. In addition, the personal computer may be able to perform advanced analysis
functions, and/or transmit data to other computers (i.e. over the internet) for improved
diagnosis and treatment. Connecting meter 102 with a local or remote computer facilitates
improved treatment by health care providers.
[0036] Figures 2 and 3 are exemplary exploded perspective and top assembled views, respectively,
of test strip 200, which may include seven layers disposed on a substrate 205. The
seven layers disposed on substrate 205 may be a conductive layer 250, an insulation
layer 216, a matrix layer 222, a first reagent layer 224 and a second reagent layer
226, an adhesive layer 260, a hydrophilic layer 270, and a top layer 280. Test strip
200 may be manufactured in a series of steps where the conductive layer 250, insulation
layer 216, matrix layer 222, first reagent layer 224, second reagent layer 226 and
adhesive layer 260 are sequentially deposited on substrate 205 using, for example,
a screen-printing process. Hydrophilic layer 270 and top layer 280 may be disposed
from a roll stock and laminated onto substrate 205 as either an integrated laminate
or as separate layers. Test strip 200 has a distal portion 203 and a proximal portion
204, as shown in Figure 2.
[0037] Test strip 200 may include a sample-receiving chamber 292 through which a blood sample
may be drawn. Sample-receiving chamber 292 may include an inlet at a proximal end
of test strip 200. An outlet or air vent is included in hydrophilic layer 270, as
will be described below. A blood sample may be applied to the inlet to fill a sample-receiving
chamber 292 so that at least two analyte concentrations may be measured. The side
edges of a cut-out portion of adhesive layer 260 located adjacent to first and second
reagent layers 224 and 226 define a wall of sample-receiving chamber 292, as illustrated
in Figure 2. A bottom portion or "floor" of sample-receiving chamber 292 may include
a portion of substrate 205, conductive layer 250, and insulation layer 216. A top
portion or "roof" of sample-receiving chamber 292 may include distal hydrophilic portion
232.
[0038] For test strip 200, as illustrated in Figure 2, substrate 205 may be used as a foundation
for helping support subsequently applied layers. Substrate 205 may be in the form
of a polyester sheet such as a polyethylene tetraphthalate (PET) material. Substrate
205 may be in a roll format, nominally 350 microns thick by 370 millimeters wide and
approximately 60 meters in length.
[0039] A conductive layer is required for forming electrodes that may be used for the electrochemical
measurement of glucose. Conductive layer 250 may be made from a carbon ink that is
screen-printed onto substrate 205. In a screen-printing process, carbon ink is loaded
onto a screen and then transferred through the screen using a squeegee. The printed
carbon ink may be dried using hot air at about 140°C. The carbon ink may include VAGH
resin, carbon black, graphite, and one or more solvents for the resin, carbon and
graphite mixture. More particularly, the carbon ink may incorporate a suitable ratio
of carbon black: VAGH resin in the carbon ink.
[0040] For test strip 200, as illustrated in Figure 2, conductive layer 250 may include
a reference electrode 210, a first working electrode 212, a second working electrode
214, a reference contact pad 211, a first contact pad 213, a second contact pad 215,
a reference electrode track 207, a first working electrode track 208, a second working
electrode track 209, and a strip detection bar 217. In the embodiment shown in Figure
2, reference electrode 210 is located in between first working electrode 212 and second
electrode 214 such that cross-talk between first and second working electrodes 212
and 214 is minimized.
[0041] Conductive layer 250 may be formed from a carbon ink. Reference contact pad 211,
first contact pad 213 and second contact pad 215 may be configured to electrically
connect to a test meter. Reference electrode track 207 provides an electrically continuous
pathway from reference electrode 210 to reference contact pad 211. Similarly, first
working electrode track 208 provides an electrically continuous pathway from first
working electrode 12 to first contact pad 213. Similarly, second working electrode
track 209 provides an electrically continuous pathway from second working electrode
214 to second contact pad 215. Strip detection bar 217 is electrically connected to
reference contact pad 211. A test meter may detect that test strip 200 has been properly
inserted by measuring a continuity between reference contact pad 211 and strip detection
bar 217.
[0042] Insulation layer 216 may include a rectangular aperture 218 that exposes a portion
of reference electrode 210, first working electrode 212, and second working electrode
214, which may be wetted by a liquid sample. The area of first working electrode 212,
second working electrode 214, and reference electrode 210 may be defined as the area
exposed to the liquid sample. In addition to defining an electrode area, insulation
layer 216 prevents a liquid sample from touching the electrode tracks 207, 208, and
209. It is believed that the functional area of a working electrode should be accurately
defined because the magnitude of the test current is directly proportional to the
effective area of the electrode. As an example, insulation layer 216 may be Ercon
E6110-116 Jet Black Insulayer™ ink that may be purchased from Ercon, Inc. The test
strip at this point may be treated with plasma. The plasma is created by high-voltage
alternating current (AC) between two or more plasma sources spaced about 100 millimeters
apart and rotated about a generally vertical axis at ambient temperatures to define
a plasma ring. The plasma ring is configured to be spaced apart from the substrate
205, which may include the test strip electrode, at a distance of approximately 5
millimeters to approximately 30 millimeters and preferably from about 10 millimeters
to about 20 millimeters. The voltage utilized by the plasma controller may be configured
to be about 5kVA and the voltage provided to the plasma electrodes is preferably less
than about 2kVA. The frequency of the AC is about 16kHz to about 20kHz. The resulting
ring of plasma, consisting of ionised, highly energetic particles is swept downstream
towards the substrate 205 using filtered and generally contaminant free compressed
air at about 1.2 bars or higher absolute pressure, preferably about 2.5 bars at a
volumetric flow rate of less than 2 cubic meter of air per hour, towards the substrate
205, which may be moving orthogonally to the flow of air at about 5 meters per minute
to about 15 meters per minute and preferably approximately 10 meters per minute. The
plasma ring may be arrayed adjacent to other plasma rings along the path of travel
of the substrates. The number of plasma rings may be from one to as many as necessary
along the path of travel of the substrate or transverse to such path to provide for
surface modification of the substrate. The plasma is used to modify the surface of
the screen printed carbon based electrodes. This surface modification or plasma treatment
is believed to increase the electrochemical activity of the carbon surface and increase
the surface energy of the printed layers allowing for better adhesion between them
and subsequently printed layers. Plasma treatment is also believed to improve the
electrochemistry of the carbon surface making the reaction with the mediator more
ideal.
[0043] Matrix layer 222 may include a mediator such as, for example, ferricyanide and a
cofactor such as, for example, nicotinamide adenine dinucleotide (NADH). In one embodiment,
matrix layer 222 may include potassium ferricyanide, NADH, Tris-HCL buffer, hydroxyethylcellulose,
DC 1500 Antifoam, Cabosil TS 610, poly (vinyl pyrrolidone vinyl acetate), Triton X-100,
calcium chloride and analar water.
[0044] First and second reagent layers 224 and 226 are each disposed on matrix layer 222,
as illustrated in Figure 2. First and second reagent layers 224 and 226 each may include
chemicals such as an enzyme which selectivity reacts with an analyte of interest such
that the analyte concentration may be determined. The reagent layer can include an
enzyme and a mediator. Exemplary enzymes suitable for use in the reagent layer include
glucose oxidase, glucose dehydrogenase (with pyrroloquinoline quinone co-factor, "PQQ"),
and glucose dehydrogenase (with flavin adenine dinucleotide co-factor, "FAD"). An
exemplary mediator suitable for use in the reagent layer includes ferricyanide, which
in this case is in the oxidized form. The reagent layer can be configured to physically
transform glucose into an enzymatic by-product and in the process generate an amount
of reduced mediator (e.g., ferrocyanide) that is proportional to the glucose concentration.
The working electrode can then measure a concentration of the reduced mediator in
the form of a current. In turn, glucose meter 102 can convert the current magnitude
into a glucose concentration.
[0045] Exemplary analytes of interest for monitoring diabetes include glucose and ketones.
In one embodiment, first reagent layer 224 may include at least one enzyme that selectively
reacts with ketones and second reagent layer 226 may include an enzyme that selectively
reacts with glucose. In another embodiment, first reagent layer 224 may include an
enzyme that selectively reacts with glucose and second reagent layer 226 may include
at least one enzyme that selectively reacts with ketones.
[0046] In one embodiment, the components in the reagent layer used to determine the ketone
concentration may include beta-hydroxybutyrate dehydrogenase (BHD), Tris-HCL buffer,
hydroxyethylcellulose, potassium ferricyanide, DC 1500 Antifoam, Cabosil TS 610, poly(vinyl
pyrrolidone vinyl acetate), Triton X-100, calcium chloride and analar water. In another
embodiment, the reagent layer used to measure ketones may include a second enzyme
such as, for example, diaphorase
[0047] Examples of enzymes suitable for use in the reagent layer for measuring glucose may
include either glucose oxidase or glucose dehydrogenase. More specifically, the glucose
dehydrogenase may have a pyrrylo-quinoline quinone (PQQ) cofactor or a flavin adenine
dinucleotide (FAD) cofactor. In one embodiment, the components in the reagent layer
that is used to determine the glucose concentration may include glucose oxidase, Tris-HCL
buffer, hydroxyethylcellulose, potassium ferricyanide, DC 1500 Antifoam, Cabosil TS
610, poly(vinyl pyrrolidone vinyl acetate), Triton X-100, calcium chloride and analar
water.
[0048] First and second reagent layers 224 and 226 may be formed from a reagent ink, which
is disposed onto matrix layer 222 and dried. Note that the reagent ink may also be
referred to as an enzyme ink or reagent formulation. A reagent ink typically contains
a liquid, such as a buffer, for dispersing and/or dissolving materials used for the
electrochemical detection of an analyte such as glucose. In one embodiment, first
and second reagent layers 224 and 226 may be screen-printed in two successive steps
onto matrix layer 222. Reagent ink may be loaded onto a screen until it is flooded.
Next, a squeegee may be used to transfer the reagent ink through the screen and onto
matrix layer 222. After the deposition, the reagent ink may be dried using hot air
at about 50°C.
[0049] In one embodiment, the area of first reagent layer 224 and second reagent layer 226
is sufficiently large to cover the entire area of first working electrode 212 and
second working electrode 214, respectively. Each of first and second reagent layers
224 and 226 include a width and a length that is sufficiently large to at least account
for the largest electrode area that may be used in test strip 200. The width of first
and second reagent layers 224 and 226 may be about 2 millimeters, which is more than
double a width of rectangular aperture 218.
[0050] Adhesive layer 260 may be disposed on test strip 200 after the deposition of first
and second reagent layers 224 and 226. Portions of adhesive layer 260 may be aligned
to be immediately adjacent to, touch, or partially overlap with first and second reagent
layers 224 and 226. Adhesive layer 260 may include a water based acrylic copolymer
pressure sensitive adhesive which is commercially available. Adhesive layer 260 is
disposed on a portion of insulation layer 216, conductive layer 250, and substrate
205. Adhesive layer 260 binds hydrophilic layer 270 to test strip 200.
[0051] Hydrophilic layer 270 may include a distal hydrophilic portion 232 and proximal hydrophilic
portion 234, as illustrated in Figure 2. A gap 235 is included between distal hydrophilic
portion 232 and proximal hydrophilic portion 234. Gap 235 serves as a side vent for
air as blood fills sample-receiving chamber 292. Hydrophilic layer 270 may be a polyester
having one hydrophilic surface such as an anti-fog coating, which is commercially
available from 3M.
[0052] The final layer to be added to test strip 200 is top layer 280, as illustrated in
Figure 2. Top layer 280 may include a clear portion 236 and opaque portion 238. Top
layer 280 is disposed on and adhered to hydrophilic layer 270. Top layer 280 may be
a polyester that has an adhesive coating on one side. It should be noted that the
clear portion 236 substantially overlaps distal hydrophilic portion 232, which allows
a user to visually confirm that sample-receiving chamber 292 may be sufficiently filled.
Opaque portion 238 helps the user observe a high degree of contrast between a colored
fluid such as, for example, blood within sample-receiving chamber 292 and opaque portion
238.
[0053] In another embodiment, the system may include a meter and test strip for measuring
one analyte, e.g., glucose, as is described in
US patent numbers 5,708,247,
5,951,836,
6,241,862, and
7,112,265, each of which is fully incorporated herein by reference.
[0054] Figure 4 shows a simplified schematic of meter 102 interfacing with test strip 200.
Meter 102 may include a reference connector 180, a first connector 182 and a second
connector 184, which respectively form an electrical connection to reference contact
211, first contact 213 and second contact 215. The three aforementioned connectors
are part of strip port 110. When performing a test, a first test voltage source 186
may apply a test voltage
VWE2 between second working electrode 214 and reference electrode 210. As a result of
test voltage
VWE2, meter 102 may then measure a test current
IWE2 at second working electrode. In a similar manner, a second test voltage source 188
applies a test voltage
VWE1 between first working electrode 212 and reference electrode 210. As a result of test
voltage
VWE1, meter 102 may then measure a test current
IWE1. In an embodiment, test voltage
VWE2 and second test voltage
VWE1 may be about equal. For simplifying the description of the following sections, the
set of instructions for determining a hematocrit corrected glucose concentration will
be described for only one working electrode and reference electrode. It should be
apparent that the embodiments should not be limited to one working electrode and reference
electrode, but that multiple working electrodes may also be utilized.
[0055] Referring to Figure 5A, a method 300 for determining a hematocrit-corrected analyte
concentration (e.g., glucose) that uses the aforementioned meter 102 and test strip
200 embodiments will now be described.
[0056] In exemplary step 310, meter 102 and test strip 200 are provided. Meter 102 may include
electronic circuitry that can be used to apply at least one test voltage to the test
strip and to measure current flowing through at least second working electrode 214.
Meter 102 also may include a signal processor with a set of instructions for the method
of determining at least one analyte concentration in a fluid sample as disclosed herein.
In one embodiment, the analytes are blood glucose and ketone.
[0057] Figure 6 is an exemplary chart of a test voltage applied to test strip 200. Before
a fluid sample is applied to test strip 200, test meter 102 is in a fluid detection
mode in which a test voltage of about 400 millivolts is applied between second working
electrode 214 and reference electrode 210. In exemplary step 320, the fluid sample
is applied to test strip 100 at
t0 and is allowed to react with first and second reagent layers 224 and 226 for a reaction
period
tR. The presence of sample in the reaction zone of test strip 200 is determined by measuring
the current flowing through second working electrode 214. The beginning of reaction
period
tR is determined to begin when the current flowing through second working electrode
214 reaches a desired value, typically about 0.150 nanoamperes (not shown), at which
point a test voltage of zero millivolts is applied between second working electrode
214 and reference electrode 10. Reaction period
tR is typically from about 2 to about 4 seconds after initiation of the measuring and
is more typically about 3 seconds after initiation of the measuring, i.e., after
t1. In exemplary step 330, after reaction period
tR, the test voltage in the subject method is applied to test strip 200 at
t1 for a total test time
tT. In an alternative method (not shown), the reaction period
tR is omitted such that the start of the test commences as soon as sufficient current
is flowing through second working electrode 214.
[0058] Figure 7 is an exemplary chart of a current transient
A (i.e., the measured electrical current response in nanoamperes as a function of time)
that is measured when the test voltage of Figure 6 is applied to test strip 200. Test
currents
Ii obtained from current transients
A are generally indicative of the analyte concentration in the sample as will be described
in exemplary step 350 below. Referring to Figures 6 and 7, in exemplary step 340,
after the test voltage is applied between second working electrode 214 and reference
electrode 210 at time
t1, a first test current
I1, a second test current
I2, and a third (or end) test current
I3 are measured at times
t2, t3, and
tT, respectively. The test voltage applied between second working electrode 214 and reference
electrode 210 is generally from about +100 millivolts to about +600 millivolts. In
one embodiment in which second working electrode 214 is carbon ink and the mediator
is ferricyanide, the test voltage is about +400 millivolts. Other mediator and electrode
material combinations will require different test voltages. The duration of first
test voltage is generally from about 4 and 6 seconds after a reaction period and is
typically about 5 seconds after a reaction period. Typically, time
ti is measured relative to time
t1. In practice, each test current
Ii is the average of a set of measurements obtained over a short interval, for example,
five measurements obtained at 0.01 second intervals starting at
ti+1, where
I ranges from 1 to 3.
[0059] Referring to Figure 5A in exemplary step 350, a hematocrit-corrected glucose concentration
may be determined with the following:

where:
G is the hematocrit-corrected glucose concentration;
I1 is the first test current;
I2 is the second test current;
I3 is the third test current;
p is a power term that determines the strength of the hematocrit correction: the greater
the magnitude of p, the greater the hematocrit correction, i.e., the larger is the
term

in Equation 1;
intercept1 is an intercept value determined from a linear regression of a plot of

versus a reference glucose concentration; and
slope1 may be a slope value determined from a linear regression of a plot of

versus the reference glucose concentration.
[0060] In one embodiment, first test current
I1 may be from about 3 seconds after a reaction period to about 4 seconds after a reaction
period t1, second test current
I2 may be from about 4 seconds after a reaction period t1 to about 5 seconds after a
reaction period t1, and third test current
I3 may be about 5 seconds after a reaction period t1. In one embodiment, first test
current
I1 may be measured at a time at which signal noise is low. For plasma treated test strip,
the first test current may be measured at about 3.5 seconds, the second test current
may be measured at about 4.5 seconds and the third test current at about 5 seconds.
For untreated test strip, the first current may be measured at about 4 seconds; the
second test current at about 4.5 seconds; and the third test current at about 5 seconds.
[0061] In one embodiment, power term p depends on a threshold value of first test current
I1 and may be from about one to about four. If first test current
I1 is above the threshold value, then Equation 1 is used to calculate the hematocrit-corrected
glucose concentration
G. If first test current
I1 is at or below the threshold value, then power term
p may be set to zero in Equation 1 and the term

becomes one. In one embodiment, the threshold value of first test current
I1 may be from about 4 microamperes to about 7 microamperes.
[0062] In another embodiment, power term
p comprises a value obtained with the following:

where
a is a first tuning parameter and
b is a second tuning parameter.
[0063] By subtracting the inverse of
I3 from first tuning parameter
a, power term p is increased for large values of
I3 and is reduced for low values of
I3, corresponding to high and low glucose concentrations, respectively. In one embodiment,
each of first and second tuning parameters
a and
b is from about zero to about five. For low glucose values, e.g., less than about 75
mg/dL, the value
of p is preferably about 1 while for other glucose values, the value of
p can be from about 1.5 to about 3.5. In exemplary step 340, the hematocrit-corrected
glucose concentration may then be displayed on meter 102.
[0064] Referring to Figure 5B, a method 400 for determining batch-specific first and second
tuning parameters
a and
b will now be described. In exemplary step 410, a plurality of combinations of first
and second tuning parameters
a and
b are provided. In an embodiment in which each of the first and second tuning parameters
may vary from about zero to about five in increments of 0.1, a total of 2601 tuning
parameter combinations are possible. In exemplary step 420, a first power term
p1 for a first combination of the first tuning parameter and the second tuning parameter
may be determined with Equation 3.
[0065] In exemplary step 430, a hematocrit-corrected current for each of a plurality of
samples tested with the batch of test strips may be determined with the following:

where
Icorrected is a hematocrit-corrected current and
p1 is the first power term.
[0066] In exemplary step 440, a
slope2 and an
intercept2 is determined from a linear regression of a plot of hematocrit-corrected current
versus a reference plasma glucose concentration.
[0067] In exemplary step 450, a hematocrit-corrected glucose concentration is determined
for each of the plurality of samples with the following:

where:
Ccorrected is a hematocrit-corrected glucose concentration;
intercept2 is the intercept value determined from a linear regression of a plot of Icorrected versus a reference glucose concentration Greference; and
slope2 is the slope value determined from a linear regression of a plot of Icorrected versus a reference glucose concentration;
[0068] In exemplary step 460, a bias for each of the hematocrit-corrected glucose concentrations
is determined with equations of the form:

where:
Biasabs is an absolute bias;
Bias% is a percent bias;
Gcorrected is defined above for Equation 4; and
Greference is the reference glucose concentration;
[0069] In exemplary step 470, an accuracy for the first combination of the first and second
tuning parameters is determined with the following:

where:
n15 is the number of data points within a bias criteria; and
n is the total number of data points;
[0070] In exemplary step 480, a hematocrit slope is determined from a linear regression
of a plot of the bias versus the percent hematocrit.
[0071] In exemplary step 490, a standard deviation of the bias (which may be a mean bias)
is determined with the following:

where:
s is the standard deviation;
n is the number of samples;
xi is the sample; and
x is the mean of the sample.
The standard deviation of the bias (which may be a mean bias) is a measure of the
noise introduced by the set of instructions.
[0072] In exemplary step 500, the previous steps for all combinations of the first and second
tuning parameters are repeated. In exemplary step 510, a surface plot 800 (Fig. 8)
of the accuracy calibration space for all combinations of first tuning parameter
a and second tuning parameter
b is generated. A region 802 of acceptable accuracy may be determined from the accuracy
calibration space. The region 802 indicates an area of greatest accuracy, approximately
±15% or about 12 mg/dL for accuracy requirement. The data generated by plot 800 is
calculated from a batch of plasma treated carbon type test strip. In one embodiment,
a minimum accuracy of 95% is used as an acceptance criterion.
[0073] In exemplary step 520, a surface plot 900 (Fig. 9) of the hematocrit slope calibration
space for all combinations of first tuning parameter
a and second tuning parameter
b is determined. A maximum negative hematocrit slope may then be determined from the
hematocrit slope calibration space. In one embodiment, the hematocrit slope acceptance
criterion is greater than -0.6 % bias per % hematocrit, which is indicated by region
902 in plot 900.
[0074] In exemplary step 530, a combined surface plot 1000 (Fig. 10) of both the accuracy
calibration space and the hematocrit slope calibration space for all combinations
of first tuning parameter
a and second tuning parameter
b is determined.
[0075] In exemplary step 540, the batch-specific first tuning parameter and second tuning
parameter is determined from the region in the combined surface plot in which the
acceptance criteria for both accuracy and hematocrit slope are met. In one embodiment,
the acceptance criterion for accuracy is greater than 95% and the hematocrit slope
acceptance criterion is greater than -0.5 % bias per % hematocrit. The batch-specific
first and second tuning parameters may then be used to determine a set of batch-specific
calibration parameters, e.g., slope and intercept, by repeating steps 420, 430 and
440 in method 400. To use the same set of tuning parameters for multiple batches of
test strips, a set of tuning parameters may be determined for each batch by method
400 and then regions of overlap in the combined accuracy and hematocrit calibration
space for all the batches may be determined. That is, combinations which pass suitable
criteria (e.g., with accuracy is greater than 95% and the slope greater than -0.6%bias
per % hct) in Figs. 8 and 9 are retained. The resulting calibration space is illustrated
by the elevated region in Figure 10.
[0076] EXAMPLE: Determination of hematocrit-corrected glucose concentration with a test strip as
shown in Figures 2 and 3.
[0077] A batch of test strips was tested with 432 whole blood samples having at least three
different glucose concentrations (i.e., 55 mg/dL, 240 mg/dL and 450 mg/dL) and hematocrit
levels ranging from 30 to 55%. The hematocrit-corrected glucose concentration was
determined for each data point in the data mapping as described previously with methods
300 and 400. A surface plot 800 of the accuracy calibration space for all combinations
of tuning parameters
a and
b was determined and is illustrated in Figure 8. The elevated region 802 in the center
of the surface plot indicates the area of acceptable accuracy, e.g., greater than
95% of the values within an International Standards Organization (ISO) bias requirement
of about +/- 15% for glucose values greater than or equal to about 75 mg/dL or about
12 mg/dL for glucose values less than about 75 mg/dL.
[0078] A surface plot 900 of the hematocrit slope calibration space for all combinations
of tuning parameters
a and
b was also determined and is shown in Figure 9 for glucose concentration greater than
about 100 mg/dL and less than about 300 mg/dL because it is believed that this range
is the most resistant to hematocrit correction. The region 902 in the center of the
plot meets the acceptance criteria for the hematocrit slope of greater than about
-0.6 % bias per % hematocrit.
[0079] Figures 8 and 9 illustrate a large calibration space that characterizes the effect
of all 2061 possible combinations of the tuning parameters on accuracy and hematocrit
slope. Visualizing the data in this manner provides a method for reducing this large
calibration space into a useful set of tuning parameters. Figure 8 suggests where
there is a region (e.g., 802) of accuracy within the acceptance criteria. This region
802 may be reduced further by considering the hematocrit slope along with the accuracy.
This may be achieved by setting acceptance criteria for both the accuracy and hematocrit
slope at each combination of tuning parameters. Using an accuracy requirement of greater
than 95% of the data within the ISO bias limits of+/- 15% for glucose values greater
than or equal to 75 mg/dL or 12 mg/dL for glucose values less than 75 mg/dL (Fig.
8) and a hematocrit requirement of greater than -0.6% bias per % hematocrit (Fig.
9), a calibration space 1000 may determined, as illustrated by the shaded region in
Figure 10. The calibration space can be reduced by using more narrow acceptance criteria,
e.g., by increasing the required accuracy and by reducing the allowed hematocrit slope
which results in a smaller set of batch-specific tuning parameters.
[0080] Once the preferred set of tuning parameters a and b are obtained from the data mapping,
they can be applied to the data set and the above is repeated to determine the slopes
and intercepts for the hematocrit compensated currents and the reference glucose values.
The tuning and calibration parameters are now set for this batch. When dealing with
multiple batches, all of the steps should be repeated for each individual batch, and
areas in the calibration space which allow the same set of tuning parameters to be
used should be found (e.g. by creating Figure 10 for each batch and looking for areas
of overlap).
[0081] Figures 11A and 11B illustrate Clarke Error Grid plots of test glucose concentration
as a function of reference glucose concentration as determined on a reference instrument.
A Clark's Error Grid analysis provides a method to access the clinical accuracy of
a blood glucose monitoring device. The error grid of such an analysis categorizes
a device's response against a reference value into one of five clinical accuracy zones
(i.e., zones A-E). Zone A indicates clinically accurate results; zone B indicates
results that are not clinically accurate but pose minimal risk to patient health;
and zones C through E indicate clinically inaccurate results that pose increasing
potential risk to patient health (see
Clarke, William L. et al., Evaluating Clinical Accuracy of systems for Self-Monitoring
of Blood Glucose, Diabetes Care, Vol. 10 No. 5, 622-628 [1987], which is incorporated by reference as if set forth herein). Specifications can
be developed based on the percent of results falling within the various error grid
zones. In the current example, it is desirable that at least 95% of the data lie within
zone A and the rest of the data lie within zone B. Figure 11A illustrates uncorrected
data from the given batch of test strips tested with 432 whole blood samples. Figure
11B illustrates the same set of data but with the hematocrit-correction of the subject
method applied to the data described previously in methods 300 and 400. A summary
of the percent of data falling within each zone is given in Table 1 below for uncorrected
data and corrected data.
Table 1: Summary of Clarke Error Grid Analysis
Zone |
Percent within Zone for Uncorrected Data |
Percent within Zone for Corrected Data |
A |
92.2 |
98.6 |
B |
6.7 |
1.2 |
C |
0.1 |
0.1 |
D |
0.9 |
0.0 |
E |
0.0 |
0.0 |
[0082] The data in Table 1 illustrates an increase in the percent of data points in Zone
A when the subject method is used to correct the data for the hematocrit effect.
[0083] The data may also be presented as a percent falling within different ISO bias criteria,
as illustrated in Table 2 below. Steps 410 - 470 of method 400 were used to determine
the percent within each bias criteria.
Table 2: Summary of Bias Results
ISO Bias Criteria (%) |
Percent within Bias Criteria for Uncorrected Data |
Percent within Bias Criteria for Corrected Data |
+/- 20 |
92.3 |
98.6 |
+/- 15 |
83.7 |
97.1 |
+/- 10 |
66.3 |
85.4 |
[0084] The data in Table 2 indicates an increase in the percent of data falling within each
ISO bias criteria when the subject method is used to correct the data for the hematocrit
effect.
[0086] Figure 11C illustrates uncorrected data from the given batch of test strips tested
with 761 whole blood samples and with outliers removed by error trapping. Figure 11D
illustrates the same set of data as in Figure 11C but with the hematocrit-correction
of the subject method applied to the data described previously in methods 300 and
400. It is desirable that at least 95% of the data lie within zone A and the rest
of the data lie within zone B. A summary of the percent of data falling within each
zone is given in Table 3 below for uncorrected data and corrected data.
Table 3: Summary of Parkes Error Grid Analysis
Zone |
Percent within Zone for Uncorrected Data |
Percent within Zone for Corrected Data |
A |
96.8 |
99.2 |
B |
3.2 |
0.8 |
C |
0.0 |
0.0 |
D |
0.0 |
0.0 |
E |
0.0 |
0.0 |
[0087] The data in Table 3 illustrates an increase in the percent of data points in Zone
A when the subject method is used to correct the data for the hematocrit effect.
[0088] In conclusion, the system and methods described and illustrated herein can be used
to determine a hematocrit-corrected glucose concentration. Thus, the glucose result
obtained with the exemplary subject system and method is believed to be more accurate.
[0089] While the invention has been described in terms of particular variations and illustrative
figures, those of ordinary skill in the art will recognize that the invention is not
limited to the variations or figures described. In addition, where methods and steps
described above indicate certain events occurring in certain order, those of ordinary
skill in the art will recognize that the ordering of certain steps may be modified
and that such modifications are in accordance with the variations of the invention.
Additionally, certain of the steps may be performed concurrently in a parallel process
when possible, as well as performed sequentially as described above. Therefore, to
the extent there are variations of the invention, which are within the spirit of the
disclosure or equivalent to the inventions found in the claims, it is the intent that
this patent will cover those variations as well.
Embodiments of the invention:
[0090]
Embodiment 1. A method for determining a glucose concentration measurable with a system
having a test strip and a meter, the method comprising:
applying a test voltage between a reference electrode and a working electrode coated
with a reagent layer disposed on a matrix layer having a mediator;
measuring a first test current, a second test current and a third test current at
the working electrode with the meter after a blood sample containing an analyte is
applied to the test strip to physically transform the analyte into an enzymatic by-product;
determining a glucose concentration from the first, second and third test currents;
and displaying the glucose concentration.
Embodiment 2. The method of embodiment 1, in which the first test current comprises
a current measured from about three to about four seconds after a reaction period
of time.
Embodiment 3. The method of embodiment 1, in which the second current comprises a
current measured from about four to about five seconds after a reaction period of
time.
Embodiment 4. The method of embodiment 1, in which the third current comprises a current
at about five seconds after a reaction period of time.
Embodiment 5. The method of embodiment 1, in which the glucose concentration comprises
a value obtained with the following:

where:
G comprises the glucose concentration;
I1 comprises the first test current;
I2 comprises the second test current;
I3 comprises the third test current;
p comprises a power term that depends on a threshold value of the first test current;
intercept1 comprises an intercept value determined from a linear regression of a plot
of

versus a reference glucose concentration for a batch of test strips; and
slope1 comprises a slope value determined from a linear regression of a plot of

versus the reference glucose concentration for the particular batch of test strip.
Embodiment 6. The method of embodiment 5, in which the threshold value of the first
test current comprises from about 5 microamperes to about 7 microamperes.
Embodiment 7. The method of embodiment 5, in which the power term comprises a value
obtained with the following:

where a comprises a first tuning parameter and b comprises a second tuning
parameter.
Embodiment 8. The method of embodiment 5, in which the power term comprises a value
from about one to about four.
Embodiment 9. The method of embodiment 7, in which batch-specific first and second
tuning parameters by a method comprising:
calculating a first power term for a first combination of the first tuning parameter
and the second tuning parameter with the following:

where p1 comprises the first power term;
ascertaining the hematocrit-corrected current for each of a plurality of samples tested
with the batch of test strips with the following:

where Icorrected comprises the hematocrit-corrected current;
computing a slope and intercept from a linear regression of a plot of hematocrit-corrected
current versus a reference plasma glucose concentration;
estimating a hematocrit-corrected glucose concentration for each of the plurality
of samples with the following:

where:
Gcorrected comprises the hematocrit-corrected glucose concentration;
intercept2 comprises an intercept value determined from a linear regression of a plot
of Icorrected versus a reference glucose concentration; and
slope2 comprises a slope value determined from a linear regression of a plot of Icorrected versus a reference glucose concentration;
evaluating a bias for each of the hematocrit-corrected glucose concentrations with
equations of the form:

and

where:
Biasabs comprises absolute bias;
Bias% comprises percent bias;
Gcorrected is defined above; and
Greference is the reference glucose concentration;
estimating accuracy for the first combination of the first and second tuning parameters
with the following:

where n15 comprises the number of data points within a bias criteria; and
n comprises the total number of data points;
computing a hematocrit slope from a linear regression of a plot of the bias versus
the percent hematocrit;
establishing a standard deviation of the bias with the following:

where:
s comprises the standard deviation;
n comprises the number of samples;
xi comprises the sample; and
x comprises the mean of the sample;
repeating the previous steps for all combinations of the first and second tuning parameters;
plotting an accuracy calibration space of the accuracy calibration space for all combinations
of the first and second tuning parameters;
plotting an accuracy calibration space of the hematocrit slope calibration space for
all combinations of the first and second tuning parameters;
generating a combined surface plot for all combinations of the first and second tuning
parameters which meet both accuracy and hematocrit slope acceptance criteria; and
determining batch-specific first and second tuning parameters from the combined surface
plot.
Embodiment 10. A method for determining at least a glucose concentration measurable
with a system having a test strip and a meter, the method comprising:
applying a test voltage between a reference electrode and a working electrode coated
with
a reagent layer disposed on a matrix layer having a mediator;
measuring a first test current, a second test current and a third test current at
the working
electrode with the meter after a blood sample containing an analyte is applied to
the test strip;
determining the glucose concentration from the first, second and third test currents
with the following:

where:
G comprises the glucose concentration;
I1 comprises the first test current;
I2 comprises the second test current;
I3 comprises the third test current;
Intercept1 and slope1 are data previously obtained from linear regression analysis
of a plot of hematocrit-corrected current versus a reference plasma glucose concentration
for a particular batch of strip;
p comprises a power term and comprises a value obtained with the following:

where a comprises a first tuning parameter and b comprises a second tuning parameter
and the tuning parameters by for a batch of test strips; and
displaying the glucose concentration.
Embodiment 11. The method of embodiment 10, in which the determining comprises:
calculating a first power term for a first combination of the first tuning parameter
and the second tuning parameter with the following:

where p1 comprises the first power term;
ascertaining the hematocrit-corrected current for each of a plurality of samples tested
with the batch of test strips with the following:

where Icorrected comprises the hematocrit-corrected current;
computing a slope and intercept from a linear regression of a plot of hematocrit-corrected
current versus a reference plasma glucose concentration;
estimating a hematocrit-corrected glucose concentration for each of the plurality
of samples;
evaluating a bias for each of the hematocrit-corrected glucose concentrations;
estimating an accuracy for the first combination of the first and second tuning parameters
computing a hematocrit slope from a linear regression of a plot of the bias versus
the percent hematocrit;
establishing a standard deviation of the bias;
repeating the previous steps for all combinations of the first and second tuning parameters;
plotting an accuracy calibration space of the accuracy calibration space for all combinations
of the first and second tuning parameters;
plotting an accuracy calibration space of the hematocrit slope calibration space for
all combinations of the first and second tuning parameters;
generating a combined surface plot for all combinations of the first and second tuning
parameters which meet both accuracy and hematocrit slope acceptance criteria; and
determining batch-specific first and second tuning parameters from the combined surface
plot.
Embodiment 12. The method of embodiment 11, in which the estimating comprises calculating
with the following:

where:
Gcorrected comprises the hematocrit-corrected glucose concentration;
intercept2 comprises an intercept value determined from a linear regression of a plot
of Icorrected versus a reference glucose concentration for a batch of test strips; and
slope2 comprises a slope value determined from a linear regression of a plot of Icorrected versus a reference glucose concentration for the particular batch of test strips.
Embodiment 13. The method of embodiment 12, in which the evaluating of the bias for
each of the hematocrit-corrected glucose concentrations comprises the following:


for Greference greater than or equal to 75mg/dL
where:
Biasabs comprises absolute bias;
Bias% comprises percent bias; and
Greference comprises the reference glucose concentration.
Embodiment 14. The method of embodiment 13, in which the estimating of the accuracy
for the first combination of the first and second tuning parameters comprises the
following:

where n15 comprises the number of data points within a bias criteria; and
n comprises the total number of data points.
Embodiment 15. The method of embodiment 14, in which the establishing of the standard
deviation of the bias comprises the following:

where:
s comprises the standard deviation;
n comprises the number of samples;
xi comprises the sample; and
x comprises the mean of the sample.
Embodiment 16. The method of embodiment 10, in which the first test current comprises
a current measured from about three to about four seconds after initiation of the
measuring.
Embodiment 17. The method of embodiment 10, in which the second current comprises
a current measured from about four to about five seconds after initiation of the measuring.
Embodiment 18. The method of embodiment 10, in which the third current comprises a
current at about five seconds after initiation of the measuring.
Embodiment 19. The method of embodiment 10, in which the power term comprises a value
from about one to about four.
Embodiment 20. A method for determining a hematocrit-corrected test current measurable
with a system having a test strip and a meter, the method comprising:
applying a test voltage between a reference electrode and a working electrode coated
with
a reagent layer disposed on a matrix layer having a mediator;
measuring a first test current, a second test current and a third test current at
the working
electrode with the meter after a blood sample containing an analyte is applied to
the test strip; and
ascertaining a hematocrit-corrected test current via a ratio of the first test
current to the second test current raised to a power term and multiplying the ratio
by the third test current, in which the power term comprises a function of a first
tuning parameter and a second tuning parameter.
Embodiment 21. The method of embodiment 20, further comprising evaluating batch-specific
first and second tuning parameters by calculating a first power term for a first combination
of the first tuning parameter and the second tuning parameter with the following:

where:
p comprises the first power term
I3 comprises the third test current; and
a and b are the first and second tuning parameters, respectively.
Embodiment 22. The method of embodiment 21, in which the ascertaining of the hematocrit-corrected
current for each of a plurality of samples tested with the batch of test strips comprises:

where:
Icorrected comprises the hematocrit-corrected current;
I1 comprises the first test current; and
I2 comprises the second test current;
Embodiment 23. The method of embodiment 22, further comprising:
computing a slope and intercept from a linear regression of a plot of hematocrit-corrected
current versus a reference plasma glucose concentration for a batch of test strip;
estimating a hematocrit-corrected glucose concentration for each of the plurality
of samples with the following:

where:
Gcorrected comprises the hematocrit-corrected glucose concentration;
intercept2 comprises an intercept value determined from a linear regression of a plot
of Icorrected versus a reference glucose concentration; and
slope2 comprises a slope value determined from a linear regression of a plot of Icorrected versus a reference glucose concentration;
evaluating a bias for each of the hematocrit-corrected glucose concentrations with
the following:

and

where:
Biasabs comprises absolute bias;
Bias% comprises percent bias; and
Greference comprises the reference glucose concentration;
estimating an accuracy for the first combination of the first and second tuning parameters
with the following:

where n15 comprises the number of data points within a bias criteria; and
n comprises the total number of data points;
computing a hematocrit slope from a linear regression of a plot of the bias versus
the percent hematocrit;
establishing a standard deviation of the bias with the following:

where:
s comprises the standard deviation;
n comprises the number of samples;
xi comprises the sample; and
x comprises the mean of the sample;
repeating the previous steps for all combinations of the first and second tuning parameters;
plotting an accuracy calibration space of the accuracy calibration space for all combinations
of the first and second tuning parameters;
plotting an accuracy calibration space of the hematocrit slope calibration space for
all combinations of the first and second tuning parameters;
generating a combined surface plot for all combinations of the first and second tuning
parameters which meet both accuracy and hematocrit slope acceptance criteria; and
determining batch-specific first and second tuning parameters from the combined
surface plot.
Embodiment 24. The method of embodiment 23, further comprising determining calibration
values with the batch-specific first and second tuning parameters.
Embodiment 25. The method of embodiment 20, in which the power term comprises a value
from about one to about four.
Embodiment 26. The method of embodiment 20, in which the first test current comprises
a current measured from about three to about four seconds after initiation of the
measuring.
Embodiment 27. The method of embodiment 20, in which the second current comprises
a current measured from about four to about five seconds after initiation of the measuring.
Embodiment 28. The method of embodiment 20, in which the third current comprises a
current at about five seconds after initiation of the measuring.
Embodiment 29. An analyte measurement system to measure at least glucose concentration
in physiological fluid of a user, the system comprising:
a test strip including a substrate having a reference electrode and a working electrode
coated with a reagent layer disposed on a matrix layer having a mediator, the electrodes
being connected to corresponding contact pads; and
an analyte meter having a test circuit in connection with a test strip port that receives
the contact pads of the test strip so that the meter is configured to apply a test
voltage after deposition of physiological fluid on the electrodes and determine a
hematocrit-corrected the glucose concentration from measured first, second and third
test currents at first, second, and third discrete intervals after application of
the test voltage by the meter.
Embodiment 30. The system of embodiment 29, in which the first test current comprises
a current measured from about three to about four seconds after initiation of the
measuring.
Embodiment 31. The system of embodiment 29, in which the second current comprises
a current measured from about four to about five seconds after initiation of the measuring.
Embodiment 32. The system of embodiment 29, in which the third current comprises a
current at about five seconds after initiation of the measuring.
Embodiment 33. The system of embodiment 29, in which no test voltage is applied for
a period of time after the deposition of the physiological fluid to provide for a
reaction time before application of the test voltage.